Verbal initiation, selection, strategy, and inhibition in stroke: A brief executive function screening tool

Area of Science:

• Neuroscience
• Cognitive Psychology
• Neurology

Background:

• Executive dysfunction is common after stroke and impacts long-term outcomes.
• Standard cognitive screens may miss subtle executive function deficits.
• Early identification of executive dysfunction is crucial for effective rehabilitation.

Purpose of the Study:

• Introduce and validate the Brief Executive Language Screen - Sentence Completion (BELS-SC) for assessing executive functions in early stroke.
• Determine the construct, convergent, and divergent validity, sensitivity, and specificity of the BELS-SC.
• Explore differences in executive function between left and right hemisphere stroke patients.

Main Methods:

• Recruited 88 acute/early sub-acute stroke patients and 116 age-matched healthy controls.
• Administered the novel BELS-SC and standard executive function tests.
• Utilized Principal Component Analysis (PCA) to analyze BELS-SC factors.

Main Results:

• The BELS-SC demonstrated good sensitivity (.84) and specificity (.80) in differentiating patient groups.
• BELS-SC subtests showed convergent and divergent validity with established measures.
• Right hemisphere stroke patients exhibited greater deficits in response inhibition compared to left hemisphere patients.
• More stroke patients were impaired on the BELS-SC than on other executive function tests.

Conclusions:

• The BELS-SC is a valid and sensitive tool for assessing multiple executive processes in early stroke.
• The BELS-SC provides insights into strategic thinking and can identify impairments missed by other tests.
• Early use of the BELS-SC can facilitate timely and targeted cognitive rehabilitation interventions.